Japanese

Title	小児精神神経疾患に関連する睡眠障害に対するramelteonの効果
Subtitle	原著論文
Authors	杉浦由希子1, 久保田雅也2, 石黒精1
Authors (kana)
Organization	1国立成育医療研究センター教育研修センター, 2神経内科
Journal	脳と発達
Volume	53
Number	6
Page	452-455
Year/Month	2021 / 11
Article	原著
Publisher	日本小児神経学会
Abstract	「要旨」【目的】小児精神神経疾患に関連する睡眠障害に対するramelteonの効果を明らかにする. 【方法】当院神経内科と総合診療部で睡眠障害(睡眠相後退症候群, 非24時間睡眠覚醒リズム, 中途覚醒)を有する患者(生後6か月から23歳)のうち2010年1月〜2017年12月の間に新規にramelteonを処方された患者について, 睡眠障害の種類, 体重あたりの薬用量, 背景疾患, 併用薬剤とramelteonの効果の関係をカルテから後方視的に検討した. 効果判定の基準としては「中途覚醒が少なくなった」, または「望ましい一定の時刻に眠れるようになった」ものを効果ありとした. 【結果】対象は210例で130例(62%)に効果を認めた. 睡眠相後退症候群が104例中67例(64%), 非24時間睡眠覚醒リズムが16例中8例(50%), 中途覚醒が44例中27例(61%)で効果が認められた. 背景疾患別では高度視力障害が16例中12例(75%), 自閉スペクトラム症30例中21例(70%), 起立性調節障害に伴う不登校37例中19例(51%), てんかん87例中56例(64%), 脳性麻痺23例中17例(74%)に効果を認めた. 有害事象は11%で認め用量との関連はなかった. 【結論】Ramelteonは小児精神神経疾患のある児に安全に使用できる薬剤であり, 特に自閉スペクトラム症, 高度視力障害, 脳性麻痺の患者の睡眠障害で有効である.
Practice	臨床医学：内科系
Keywords	ramelteon, 睡眠障害, 小児精神神経疾患, sleep disorder, children and adolescents with neuropsychiatric disease

English

Title	Effectiveness of ramelteon in children and adolescents with neuropsychiatric disease-related sleep disorders
Subtitle	Original Articles
Authors	Yukiko Sugiura1, Masaya Kubota2, Akira Ishiguro1
Authors (kana)
Organization	1Center for Postgraduate Education and Training, and 2Division of Neurology, National Center for Child Health and Development
Journal	NO TO HATTATSU (Official Journal of The Japanese Society of Child Neurology)
Volume	53
Number	6
Page	452-455
Year/Month	2021 / 11
Article	Original article
Publisher	The Japanese Society of Child Neurology
Abstract	[Objective]: To clarify the effectiveness of ramelteon in children and adolescents with neuropsychiatric diseases with comorbid sleep disorders. [Methods]: This is a retrospective review of patients aged 6 months to 23 years who were prescribed ramelteon for their sleep disorder (delayed sleep phase syndrome, non-24-hour sleep-wake disorder, and nocturnal awakening) in the Division of Neurology and General Pediatrics between January 1, 2010, and December 31, 2017. We Studied the association between the effectiveness of ramelteon and the type of sleep disorder, the dosage of ramelteon per body weight, comorbidities, and other medications taken. Criteria for effectiveness were defined as less awakening or sleep at a desired time. [Results]: The overall success rate was 130/210 (62%). We could note the effectiveness of ramelteon in 67/104 (64%) patients with delayed sleep phase syndrome, 8/16 (50%) with non-24-hour sleep-wake disorder, and 27/44 (61%) with nocturnal awakening. Regarding comorbidities, ramelteon showed effectiveness in 12/16 (75%) of those with severe visual impairment, 21/30 (70%) with autism spectrum disorder, 19/37 (51%) with school absenteeism with orthostatic dysregulation, 56/87 (64%) with epilepsy, and 17/23 (74%) with cerebral palsy. Adverse events were seen in 11%, which had no association with the dosage per weight. [Conclusions]: We can use ramelteon safely for sleep disorders in children and adolescents with neuropsychiatric diseases, and expect its effectiveness in those patients with autism spectrum disorder, severe visual impairment, and cerebral palsy.
Practice	Clinical internal medicine
Keywords	ramelteon, sleep disorder, children and adolescents with neuropsychiatric disease

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